Human rights promotion and the 'Geneva impasse' in mental healthcare: scoping review

BJPsych Open. 2023 Apr 11;9(3):e58. doi: 10.1192/bjo.2023.50.

Abstract

Background: The World Psychiatric Association recently emphasised that the protection of human rights in mental healthcare was a 'central concern'. This paper examines recent literature on human rights and mental healthcare.

Aims: To (a) outline how international human rights law distinguishes between the protection and promotion of human rights; and (b) explore the literature on promoting human rights in mental healthcare which avoids what has been termed the 'Geneva impasse' between those who argue that compulsory care and treatment can never comply with human rights law and those who argue that they can if certain conditions are met.

Method: The following doctrinal methodology was used: (a) identification and detailed analysis of international human rights conventions and commentaries; (b) identification of key literature on human rights and mental healthcare; and (c) critical analysis of key issues emerging from the literature.

Results: Much of the literature on human rights and mental healthcare focuses on whether restrictions on compulsory care are required to meet the requirements of United Nations Conventions. There is an emerging literature identifying measures to promote the right to the enjoyment of the highest attainable standard of mental health.

Conclusions: There has been a focus on protecting the rights to liberty and equality before the law for mental health patients. The nascent literature on promoting human rights in mental healthcare could mark a way forward beyond the 'Geneva impasse' that has dominated public debate in recent years.

Keywords: Convention on the Rights of Persons with Disabilities; Human rights; coercion; compulsory treatment; positive and negative rights.